Grading referrals to specialist breast unit may be ineffective

doi:10.1136/bmj.324.7348.1279/a

BMJ 2002;324:1279 ( 25 May )

Letters

Grading referrals to specialist breast unit may be ineffective

The first 150 words of the full text of this article appear below.

EDITOR $---$ Since the two week directive was introduced considerable debate has been surrounding certain aspects of it, especiallyhow appropriate it is for general practitioners to determine urgency.¹It was our aim to examine how effective general practitioners'grading of urgency of referrals to our unit has been, comparingthe referral grade with the eventualdiagnosis.

The database of the breast unit at King's College Hospital retrospectively examined all general practitioners' referrals tothe symptomatic breast clinic between April 1999 and December2000. Altogether 3597 referrals were made, 665 were marked asurgent and 2932 as non-urgent. Sixty two urgent patients and 49non-urgent patients were subsequently found to have breast cancer.The mean ages were 60.5 years in the non-urgent group and 59.9years in the urgentgroup.

It is evident that the two week wait initiative is not ensuring that most patients with symptomatic cancer are seen withintwo weeks of referral. This . . . [Full text of this article]

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